Advances in the healing of burns in the 21st century

It is often difficult to determine which specific discoveries have represented significant changes in the healing of burns. The areas in which most progress has taken place, and in which the results obtained until now have improved the most, include intensive cures, treatment of burn wounds, control of hypermetabolic response and control of infections. The rate of mortality and time of hospital stay have been reduced enormously over the past 25 years. In the 1960s the probability of survival was only 50% for patients with burns affecting 35/44% of their TBSA (total body surface area), while very few patients with burns affecting 45% of their TBSA managed to survive. Today, the LB50 (proportion of surface burned that is lethal for 50% of patients) in the case of children and young people exceeds 95% of TBSA, and the average hospital stay for most serious burn victims tends to be half a day for each percent of TBSA burned. This is a real achievement and an amazing testimony to the concentration of efforts in staff and resources that have been used for patients with severe burns. Specific aspects in the burns healing that have improved spectacularly in hospitals include treatments for improving wounds (invasive and non-invasive), early extirpation and grafts (including artificial tissues), infection control and strengthening of the immune system, improvements in response to nutritional and metabolic needs (new nutrition methods, recombining hormones and anabolizing agents), the creation of effective skin banks, control of infections, new materials and strategies for scarring of wounds, the application of therapies with stem cells and the introduction of allotransplants with complex tissues.